Undiagnosed HIV Infection: What We Don't Know Can Hurt Us

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Summary and CommentUndiagnosed HIV Infection: What We Don't Know Can Hurt UsThe percentage of HIV infections in the U.S. that are undiagnosed is particularly high among blacks, high-risk heterosexual men, and young people.Of the estimated 1.1 million Americans living with HIV infection, 21% do not know that they are infected. Which groups are most likely to have undiagnosed HIV infection? CDC researchers used a back-calculation method

and HIV/AIDS surveillance data to estimate the prevalence of both diagnosed and undiagnosed infections in 2006.The percentage of infections that were undiagnosed varied substantially by race/ethnicity, age, and risk group:22% for blacks and Hispanics, versus 19% for whites48% for those aged 13–24, versus 28% for those aged 25–34 and <20% for those aged 3527% for men with high-risk heterosexual contact, 24% for men who have sex with men (MSM), and 14% for injection-drug users. Among MSM, substantial differences were seen by race/ethnicity: 27% for blacks versus 20% for whites.Overall, the estimated rate of undiagnosed HIV infection was nine times higher in blacks than in whites; among Hispanics, the rate was three times higher than in whites.Comment: Individuals who do not know that they are HIV-infected cannot receive potentially life-saving therapy. Moreover, they are less likely to take precautions to avoid transmitting the infection — a fact that may explain the continued high incidence of HIV infection in the U.S. (JW Infect Dis Aug 13 2008). Thus, undiagnosed HIV infection can jeopardize both the individual's and the public's health. Programs

should be developed to lower the percentages of undiagnosed HIV infection in high-risk groups. At the same time, we must expand HIV testing to all adults. Indeed, a universal testing program is the cornerstone of the new test-and-treat strategy that is creating considerable buzz in the world of HIV prevention (JW AIDS Clin Care Dec 15 2008).— Rajesh T. Gandhi, MDPublished in Journal Watch Infectious Diseases December 16, 2009Citation(s):Campsmith ML et al. Undiagnosed HIV prevalence among adults and adolescents in the United States at the end of 2006. J Acquir Immune Defic Syndr 2009 Oct 15; [e-pub ahead of print]. (http://tinyurl.com/yh79fju) Regards, Vergelpowerusa dot org